tbuckley/cabot-search huggingface dataset:
AB0042 AUTOPHAGY IS DECREASED IN BONE FROM OSTEOPOROTIC PATIENTS
Authors: M. C. Trojani, C. Arnaud, B. Isabelle, R. Bernard De Dompsure, J. F. Gonzalez, C. Trojani, S. Santucci, G. F. Carle, V. Pierrefite-Carle, V. Breuil
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoporosis (OP) is a diffuse skeletal pathology characterized by major bone fragility that affects one out of 3 women after menopause. In addition to estrogen loss, an increase in oxidative stress is now recognized as a central mechanism in this pathology. Autophagy is an intracellular process allowing the removal and recycling of damaged proteins and organelles. Thanks to the elimination of damaged mitochondria, which are the main sources of reactive oxygen species, autophagy plays a major role in reducing oxidative stress. An age-related autophagy decline, associated with various experimental arguments in animal models, suggests autophagy implication in OP. However, a definitive proof in humans remains to be obtained. <h3>Objectives</h3> Our objective was to show for the first time that there is a defect in autophagy in the bone of osteoporotic patients. <h3>Methods</h3> We have analyzed autophagy by Western Blot in bone samples from 14 postmenopausal women with OP fracture compared to 30 controls undergoing total hip replacement for osteoarthritis. <h3>Results</h3> Our results indicate that the expression level of the autophagosome marker LC3-II is significantly decreased in OP patients compared to the age-matched controls. We also observed a tendency for the accumulation of the SQSTM1/p62 protein, which is an autophagy substrate, thus supporting the previous results. Finally, we also demonstrate a significant decrease in the hormonally up-regulated neu-associated kinase (HUNK) in bone samples from OP patients compared to the control group. This kinase, whose expression is upregulated by female hormones, promotes autophagy by inhibiting the autophagy inhibitor Rubicon through phosphorylation. <h3>Conclusion</h3> Taken together, these data demonstrate for the first time that OP patients have a deficit in osteocytes autophagy and suggest the involvement of the HUNK kinase in OP pathogenesis. This study should contribute to better understand the role of autophagy in OP pathophysiology and could lead to the design of new therapeutics targeting autophagy for the management of pathological aging. <h3>Acknowledgements</h3> We thank the French Society of Rheumatology for their funding. <h3>Disclosure of Interests</h3> None Declared.
POS1334 WORK PARTICIPATION AND WORK DISABILITY IN BELGIAN PATIENTS WITH SYSTEMIC SCLEROSIS
Authors: I. Desimpele, A. S. De Craemer, L. Delmez, D. Elewaut, P. Carron, F. Van den Bosch, V. Smith
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc) is an immune-mediated connective tissue disease that potentially affects multiple organ systems. Besides health-related complications, patients often describe work-related difficulties (e.g. productivity loss, sick leave, work disability) that may result in a major individual burden and the rise of indirect costs for society. <h3>Objectives</h3> Despite the rheumatology community's growing interest, work participation and its influencing factors is still an underrecognized and underexplored field of research in SSc patients. This study therefore aims to provide up-to-date data about work status and its determinants in SSc patients. <h3>Methods</h3> Adult SSc patients were questioned on their socio-economic status at the occasion of an outpatient visit at the rheumatology clinic of Ghent University Hospital, a tertiary hospital in the Flemish region (February 2020 to March 2021). All patients were included in a SSc clinical care path (Belgian Systemic Sclerosis Cohort) and fulfilled the LeRoy and Medsger's classification criteria. Employment rate was compared with general Flemish population after adjustment for age and sex. Comparative data on the average duration of working life in Belgium were derived from Eurostat (reference year 2020). <h3>Results</h3> Among the 108 participants, 81 (75%) belonged to the working age category (18-65 y/o). The crude employment rate in SSc patients of work-productive age was 64%, resulting in a standardized employment ratio of 0.90 (95%CI 0.69-1.17). About half of these patients worked full time (53%), with a mean±SD of 41.7±8.7 weekly working hours. The median duration of labor force participation in SSc patients was 40.0 years, while the average career duration in the Belgian population amounted 33.4 years. Long term work disability was reported as the most common reason for leaving the labor market (20%). Patients on work disability were significantly older, less highly educated, more functionally disabled and reported a lower quality of life than patients having a paid job. Job characteristics did not differ significantly between patients with and without a paid job (Table 1). <h3>Conclusion</h3> Our data refute the common perception that SSc patients show a significantly lower work participation grade compared to the general population. Socio-demographic but not job-related characteristics are associated with work disability in this population. Quality of life is remarkably better in patients who perform a paid job, reinforcing the importance to support active labor force participation. <h3>Acknowledgements</h3> I have no acknowledgementThe Ghent University Hospital is member of the Flemish Network on rare connective tissue diseases and of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET).s to declare. <h3>Disclosure of Interests</h3> None Declared.
AB0556 OFF LABEL USE OF TARGETED THERAPIES IN SLE: SINGLE CENTER EXPERIENCE FROM THE ATTIKON LUPUS COHORT
Authors: G. S. Moysidou, D. Katsifis Nezis, E. Sampatakaki, K. Kouna, M. Kosmetatou, S. Flouda, A. Filippopoulou, K. Zoupidou, D. Tseronis, M. Aggelakos, T. Karageorgas, P. Katsimpri, A. Fanouriakis, D. Boumpas
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Despite recent advances in the management of rheumatic diseases with the emergence of new targeted therapies, treatment options remain limited in systemic lupus erythematosus (SLE) [1] and disease may be refractory to conventional treatment. <h3>Objectives</h3> To evaluate the off-label use of biologics in a large cohort of lupus patients, its safety and efficacy. <h3>Methods</h3> Retrospective analysis of the Attikon SLE lupus cohort comprising over 800 patients in total in order to identify patients receiving off-label targeted therapies. Indication of the treatment, clinical characteristics and outcomes were recorded. <h3>Results</h3> A total of 52 patients received 54 off-label targeted therapies. Most of them were women (86.3%). Mean age (SD) at SLE diagnosis was 46.4 (15.2) years and mean disease duration (SD) at off-label treatment initiation was 8.8 (10.8) years. Mean SLEDAI (SD) before treatment initiation was 6.6 (3.7). The most frequently used off-label treatment was rituximab (84.6%) followed by tocilizumab (9.6%) and jak inhibitors (5.8%). The main indications were persistent, severe, refractory musculoskeletal and mucocutaneous activity (44.2%), neuropsychiatrical SLE (23.1%), hematological disease (13.5%) and lupus nephritis (11.5%).Six months after treatment, mean SLEDAI decreased in all patients to a mean of 4.3 (2.7). Mean drug survival was 2.2 (1.2) years. The dose of corticosteroids after 6 months of treatment was substantially decreased to 4.3 mg (versus 12.7 at baseline). No moderate/severe adverse effects were recorded. <h3>Conclusion</h3> The use of off-label targeted therapies allows disease activity improvement with a corticoid sparing effect even in a subset of patients with long-standing, refractory manifestations. <h3>Reference</h3> [1]Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Boletis JN, Cervera R, Doria A, Gordon C, Govoni M, Houssiau F, Jayne D, Kouloumas M, Kuhn A, Larsen JL, Lerstrøm K, Moroni G, Mosca M, Schneider M, Smolen JS, Svenungsson E, Tesar V, Tincani A, Troldborg A, van Vollenhoven R, Wenzel J, Bertsias G, Boumpas DT. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019 Jun;78(6):736-745. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0331 CHEST HIGH-RESOLUTION COMPUTED TOMOGRAPHY IN PATIENTS WITH LONG STANDING RHEUMATOID ARTHRITIS: IS THERE ANY BENEFIT?
Authors: K. Tahir, N. Akasbi, I. El Mezouar, T. Harzy
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pulmonary involvement is a frequent and severe extraarticular manifestations of rheumatoid arthritis (RA). Chest high resolution computed tomography (HRCT) have been shown to be of interest in the detection and characterization of morphological changes in the lungs of RA patients. <h3>Objectives</h3> The aim of our study was to investigate the prevalence and types of pulmonary involvement in patients with longstanding RA using chest HRCT. <h3>Methods</h3> A retrospective study was conducted in a single rheumatology hospital in Morocco, including patients diagnosed as having RA according to the ACR/EULAR 2010 criteria from Avril 2018 to Avril 2022. Longstanding RA was defined as disease duration &gt; 2 years. All patients underwent chest X-ray and chest HRCT. <h3>Results</h3> Our study included 148 patients with longstanding RA. The cohort was predominantly female (87,2%) with a mean age of 60,56 ± 11,79 years. 8 patients (5.4%) had a history of smoking. Mean age at RA onset was 44,77 ± 12,82 years and disease duration was 14,75 ±7,55 years. The mean BMI was of 28,19 ± 6.47 Kg/m2. RA was seropositive in 95,3 %, erosive in 91,2% and deforming in 66,2 % of our subjects. Methotrexate was used in 142 patients (95,9%). 41 patients (27.7%) were complaining of respiratory symptoms: dyspnea (n=20, 13.5%), cough (n=11, 7.4%), and both (n=10, 6.8%). The chest X-ray abnormalities were present in 41 patients (27,7%). Abnormal spirometry was found among 49.4% of subjects. Pulmonary HRCT abnormalities were found in 60,8% of patients and the most common were: subpleural micronodules (25 %), bronchiectasis (23,6%), non-septal linear opacities (16,9 %), pulmonary nodules (11,5%), ground glass opacity (10,8%), reticulation (8.8%) and honeycombing (8,8%). The presence of HRCT pulmonary lesions was associated with smoking history (p=0,020), seropositivity (p=0,010), respiratory symptoms (0,002) and chest X-ray changes (&lt; 0,0001). However, there were no significant association with the other clinical, biological, radiological and therapeutic criteria. <h3>Conclusion</h3> Our study confirms that a large proportion of patients with longstanding RA has abnormal findings in chest HRCT even in those with no chest X-ray findings or respiratory symptoms. RA patients should undergo chest HRCT to detect pulmonary abnormalities as early as possible. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0269 RHUMATOID FACTORS ISOTYPES DIAGNOSTIC SENSITIVITY AND SPECIFICITY IN RHUMATOID ARTHRITIS PATIENTS IN TUNISIA
Authors: R. Ben Tekaya, J. Mahbouba, M. Elghali, N. Hafdhouni, A. Saad, S. Zrour, I. Bejia, M. Touzi, N. Sakly, N. Bergaoui
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid factor (RF) is a well-established marker for the diagnosis and classification of rheumatoid arthritis (RA). Most studies have evaluated IgM RF or isotype-nonspecific total RF tests. <h3>Objectives</h3> We evaluated the importance of rheumatoid factor isotype in this study. <h3>Methods</h3> An international cohort consisting of samples from 52 RA patients and 57 patients suffer from other rheumatologic deseases were tested for IgA, IgM and IgG RF. Clinical and biological data were collected. <h3>Results</h3> IgM, IgA, and IgG were positive in RA patients 96,15%, 88,46% and 17,3% respectively. The sensitivity of IgG RF for the diagnosis of RA was the lowest 16,7%, IgA RF sensitivity was lower than IgM RF (87,8% vs 95,9%). The specificity of IgM, IgA and IgG RF for the diagnosis of RA were (29,8 %vs 61,4 %vs 89,4% respectively). Double positivity for RF IgM and RF IgA had a higher specificity for RA than RF IgM or RF IgA (92.6% vs. 29,8% vs 89,4%). However, combined positivity for IgA RF, IgM RF, and IgG ACPA had higher specificity and lower sensitivity for RA classification than positivity for either antibody. <h3>Conclusion</h3> IgA RF showed lower sensitivity than IgM RF. The combination of IgA RF with IgM RF and ACPA did not improve the sensitivity of RA classification. Combined positivity (IgA-RF/IgM-RF/ACPA) increased specificity. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0735 THE EFFECT OF NEW CLASSIFICATION CRITERIA ON THE DIAGNOSIS OF LARGE VESSEL VASCULITIS
Authors: C. Mukhtyar, C. Beadsmoore, F. Coath, G. Ducker, K. Sisson, R. Watts
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> GCA and Takayasu arteritis are the two recognised forms of LVV. In addition, there is recognition of LVV which are not easily classified into the two forms. Classification criteria have been proposed since 1990 and have been recently updated. Classification criteria should be able to minimise the number of cases that are unclassifiable and the number of cases that are classified into more than one set. We used both sets of criteria to test their performance in our cohort. <h3>Objectives</h3> To study the performance of large vessel vasculitis classification criteria in a real world cohort. <h3>Methods</h3> Between January 2011 to December 2020, 270 individuals were diagnosed as having LVV by virtue of having either a positive biopsy, ultrasonography, or PET scan. The ACR 1990 and the ACR/EULAR 2022 classification criteria were applied on our cohort. <h3>Results</h3> The mean age was 74. 181 were female. Using the 1990 criteria, 2 individuals met both classifications and 30 did not meet either. Using the 2022 criteria, 3 individuals met both classifications and 24 did not meet either. The numbers classified as having TAK has reduced from 13/270 to 2/270. The numbers classified as GCA have increased from 225/270 to 241/270. (Figure 1) <h3>Conclusion</h3> The new classification criteria have expanded the phenotype recognised as having GCA by including previously unclassified individuals, and narrowed the phenotype recognised as having Takayasu mostly by declassifying it as not meeting any criteria. Overall, the new criteria improve classification for 5/270 (1.8%) cases. <h3>References</h3> [1]Hunder GG, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990 Aug;33(8):1122-8. [2]Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990 Aug;33(8):1129-34. [3]Ponte C, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Ann Rheum Dis. 2022 Dec;81(12):1647-1653. [4]Grayson PC, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis. 2022 Dec;81(12):1654-1660. <h3>Acknowledgements</h3> National Health Service. Norfolk and Norwich Hospitals Charity. <h3>Disclosure of Interests</h3> None Declared.
AB0712 INFLUENCE OF GLUCOCORTICOID THERAPY ON TEMPORAL ARTERY BIOPSY. EXPERIENCE IN A REFERRAL HOSPITAL
Authors: J. Sanchez-Martin, J. Medina-Del Valle, J. Loricera, C. González-Vela, M. F. Garcia-Reija, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The relationship between corticosteroid (GCs) treatment prior to temporal artery biopsy (TAB) and a negative result in giant cell arteritis (GCA) is controversial. <h3>Objectives</h3> To assess whether cumulative GCs dose and time of steroid exposure influence in TAB result. <h3>Methods</h3> Observational study of 191 patients diagnosed with GCA from a clinical practice of a referral center between January 2016 and December 2022 who underwent TAB. The diagnosis of GCA was made according to <b>a</b>) ACR criteria, and/or <b>b</b>) temporal artery biopsy, and/or <b>c</b>) EULAR/ACR2022 criteria, and/or <b>d</b>) imaging techniques. The biopsies were transversally sectioned into pieces and were cut from paraffin blocks and stained with hematoxilyn-eosin. A comparative study between patients with positive TAB and those with negative TAB was performed. <h3>Results</h3> The 191 GCA patients were divided into 2 subgroups: <b>a</b>) patients with positive TAB (n=52), and <b>b</b>) patients with negative TAB (n=139) <b>(Table 1</b>) of whom 26 (13.6%) had not received prior corticosteroid therapy versus 165 (86.4%) patients who did. Patients with positive TAB had more frequently visual symptoms and/or jaw/lingual claudication, while polymyalgia rheumatica (PmR) was less frequent. The median dose [interquartile range (IQR) 25<sup>th</sup>-75<sup>th]</sup> in the negative TAB group was 40 [25-40] mg/day and also 40 [35-60] mg/day in the positive TAB group. The median duration [IQR] of treatment in the first group was 11 [4-24] days. while in the second group it was 7 [3-13] days. The percentage of positive TAB was higher the shorter the delay between GCs treatment onset and the TAB, decreasing after 15 days from GCs therapy onset <b>(Figure 1</b>). Finally, the cumulative pre-biopsy GCs dose was calculated with a median [IQR 25<sup>th</sup>-75<sup>th]</sup> of 484 [225-1295] mg for negative TAB patients while it was 760 [360-2185] mg in positive TAB cases. <h3>Conclusion</h3> Most patients with GCA were receiving GCs at the time of the TAB. Longer exposure to GCs increases the likelihood of a negative TAB, especially after 15 fays from GCs therapy onset. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1555 MEASUREMENT OF COMMON FEMORAL VEIN WALL THICKNESS IS A USEFUL DIAGNOSTIC TOOL TO DIFFERENTIATE OCULAR BEHÇET’S DISEASE FROM OTHER INFLAMMATORY UVEITIS
Authors: S. Kutluğ Ağaçkiran, E. Kardes, A. Ağaçkiran, H. Direskeneli, F. Alibaz-Oner
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Diagnosis of Behçet's Disease (BD) can be challenging, especially in patients presenting with single major organ involvement. Our group showed that common femoral vein (CFV) wall thickness measured by Doppler ultrasonography (US) can be a non-invasive diagnostic method [1] and can also be used to diagnose incomplete BD [2]. Since ocular involvement of BD may result in irreversible vision loss if untreated, it is important to diagnose without delay and initiate immunosuppressive therapy promptly. <h3>Objectives</h3> In this study, we aimed to assess the discriminative role of CFV wall thickness measurement in uveitis associated with BD compared to other inflammatory uveitis. <h3>Methods</h3> Patients with BD uveitis (n=41) and age-gender matched 58 non-BD uveitis patients were included in the study. Demographics, clinical characteristics, and treatment data were recorded during routine visits. CFV wall thickness was measured by an experienced and blinded radiologist on the same day. <h3>Results</h3> Twenty-four (58.5%) of BD patients and 23 (39.7%) of non-BD patients were male. All BD patients had panuveitis. 3 (3.0%), 8 (8.1%), 8 (8.1%) of non-BD patients have anterior uveitis due to sarcoidosis, HLA-B27 positivity, ankylosing spondylitis, respectively, and 7 (7.1%) had idiopathic anterior uveitis. 12 non-BD patients had panuveitis caused by sarcoidosis. The most common complaint was decreased visual acuity in both groups. Right CFV (0.73 mm± 0.08) and left CFV (0.73 mm± 0.07) wall thickness of BD patients was significantly higher than right and left CFV (0.57 mm± 0.1 for both) wall thickness of non-BD patients (p &lt; 001). <h3>Conclusion</h3> Diagnosis of ocular BD can be challenging, especially when there is no other clinical finding or organ involvement specific to BD. Our results suggest that measurement of CFV wall thickness by Doppler US can be helpful for the differentiation of ocular BD from other causes of inflammatory uveitis in daily practice. <h3>References</h3> [1]Alibaz-Oner F. et al. Femoral vein wall thickness measurement: A new diagnostic tool for Behçet's disease. Rheumatology (Oxford). 2021;60(1):288-96. [2]Alibaz-Oner F. et al. Common Femoral Vein Thickness Measurement as a diagnostic test in Incomplete Behçet\'s Disease. Epub ahead of print April 1, 2022. DOI: 10.5281/zenodo.640588 (presented as a poster in International The Vasculitis and ANCA Workshop) <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1193-HPR AN EVALUATION OF PATIENT EXPERIENCE OF THE BELFAST HEALTH AND SOCIAL CARE TRUST RHEUMATOLOGY ETANERCEPT BIOSIMILAR SWITCH PROGRAMME
Authors: M. Mcverry, P. Mckee, J. Thompson, S. Jacklin
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Belfast Health and Social Care Trust Rheumatology department commenced a biosimilar switch programme in July 2019, switching patients from Etanercept (Enbrel) to biosimilar (Benepali). Patients attended a bespoke switch clinic providing education and training before proceeding with biosimilar switch. <h3>Objectives</h3> To evaluate patients' experience of the Etanercept biosimilar switch programme including understanding of, attitudes towards and satisfaction with the switch process. <h3>Methods</h3> A service evaluation of patients invited to undergo biosimilar switch was undertaken. Ethical approval was not required. Patients' views were surveyed with a web-based questionnaire via text message/QR code or completed via telephone by an evaluator entering responses into the survey-tool. <h3>Results</h3> 182/342 patients responded (53%). Most [171 (94%)] reported discussing biosimilars with a healthcare-professional, received written information [174 (96%)] and felt adequately informed [172 (95%)]. 140 (77%) thought the reason for switching was to save money and 83 (45%) understood biosimilars as "<i>A highly similar but not identical copy of a biologic medicine</i>". Most [118 (65%)] reported a shared decision-making process but 52 (28%) thought "<i>Rheumatology team alone decided</i>". Most [126 (69%)] had no reservations about biosimilars, but 53 (29%) were concerned about its effectiveness. Mean visual analogue score for confidence in the biosimilar was 7.51 (median 8, 1-10). 168 (92%) reported switching to biosimilar agent. 103/168 (61%) reported no problems afterwards. Switch-back rate was 13% (22/168). 95% (161/168) rated support provided afterwards as adequate or better. Mean visual analogue score for satisfaction was 7.84 (median 8, 1-10). <h3>Conclusion</h3> The Etanercept biosimilar switch programme was successful with high switch rates, high levels of patient confidence and satisfaction. Recommendations for future include improving the process of shared decision-making during consultation to ensure fully informed patient consent. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.